Barriers to Utilising Data in Private Health Insurance
4 Jul

Barriers to Utilising Data in Private Health Insurance

This post is from guest contributor Emma Morgan, Industry Marketing Manager – Banking, Finance and Insurance at Fuji Xerox Australia.

The private health insurance industry faces several challenges that inhibit its ability to address customer concerns, according to leading authorities in the field.

At a breakfast briefing hosted by the Australian Information Industry Association (AIIA) on June 27, speakers from Medibank and Ernst & Young pointed out that effective data collection and retention offered significant opportunities for the industry to streamline health initiatives, but privacy concerns have hindered progress in their development.

The need for investment in big data is well established and understood by the private health insurance industry. The better use of data would undoubtedly lead to better patient outcomes, but several barriers currently hold back insurers’ ability to utilise information and confidently make investments in resources and systems. Providers recognise that data is key, but they have not been able to leverage data as effectively as other industries.

One such barrier is privacy. Compliance with privacy laws while sharing patient data, and consumer concerns about the use of their sensitive information are compelling insurers to be more cautious in their use of information than some other industries. The concern for patient privacy is driving insurers and healthcare providers to look for appropriately secure systems to manage patient data. This in turn has reduced their agility to maximise their opportunities with the data they have.

The disconnect between the public and private health systems is another barrier to effective data management. If a patient was treated in a public hospital and then moved to a private hospital, their health information cannot be transferred efficiently, even though they were being treated continuously for the same condition. A link between the Medicare and private systems would ameliorate this.

Another major competitive force currently affecting the health insurance industry is the prices of premiums. Consumers seek products that provide the most value at the lowest cost. As premiums continue to rise, consumers are shopping around for better deals when they renew their policy rather than remaining loyal to their existing provider.

Both consumers and private health insurers wish for greater transparency in private insurance coverage, and the costs involved in private health care. Accurate, readily accessible data is a key factor in better understanding the complexities of insurance coverage. Insurers wish to invest more heavily in data systems and IT experts, to ensure that their members receive the best and most effective care possible.

While these challenges are not insignificant, it is evident that insurers comprehend the potential in fully utilising patient data, and the inherent value in ensuring their patients are provided with the best care. Insurance providers must continue to take steps to better understand the needs and concerns of customers and, at an industry level, collaborate to voice the benefits of collecting and sharing patient data.

This in turn would assist in affording consumers the best care — and the best value from their health insurance.

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